Adolescent Health

In 2007, The Lancet published its first adolescent health series: this second series in 2012 on adolescent health argues that "it is now time to put the young person, not the specific issue, centre stage. Four papers analyse the role of adolescence as a foundation for future health, the social determinants of adolescent health, the potential of the worldwide application of prevention science, and the current availability of data on 25 suggested core indicators in all countries."

The series includes both papers and articles of comment, freely available for those registered (registration is free of charge on The Lancet website.) [Note: Once the reader is registered and logged in on The Lancet website, titles below are accessible by The Lancet title search or through the link to the series below. Footnotes are removed by the editor throughout this summary]:

Comments:

• Adolescent health in the 21st century

Robert W Blum, Francisco I P M Bastos, Caroline W Kabiru, Linh C Le
 "....Many of the behaviours we associate with the teenage years (eg, risk taking) are evident in other species, and we know that brain maturation in human beings is not complete until about age 25 years. As young people enter adolescence they bring with them resources and vulnerabilities, both biological (genetics, epigenetics, natural endowments) and environmental (national and local policies, as well as community, school, workplace, peers, neighbourhood, and family influences). Consequently, an ecological or life-course framework is crucial to understanding adolescent trajectories..."

• Seizing the opportunities of adolescent health

Michael D Resnick, Richard F Catalano, Susan M Sawyer, Russell Viner, George C Patton
"...Building a worldwide agenda for adolescent health needs an escalation in the visibility of young people and an understanding of challenges to their health and development. It needs implementation of strategies that will ensure a successful transition to adulthood. Systematic measurement of adolescents' health is integral to increasing their visibility. Better worldwide data collection is needed, with the capacity to disaggregate data to make the health of adolescents and young adults more visible..."

• Progress for children: a report card on adolescents

Claudia Cappa, Tessa Wardlaw, Catherine Langevin-Falcon, Judith Diers
The United Nations Children's Fund (UNICEF) has devoted its upcoming publication to adolescents. Progress for Children: A Report Card on Adolescents brings together data and evidence from different sources to illustrate what is known about adolescents' wellbeing today. It provides an overview of the situation of adolescents worldwide and regionally - who they are, where they live, and how their needs are (or are not) being met. [See Related Summaries below.]

Papers:

1. Adolescence: a foundation for future health
Susan M Sawyer, Rima A Afifi, Linda H Bearinger, Sarah-Jayne Blakemore, Bruce Dick, Alex C Ezeh, George C Patton
"...The shape of adolescence is rapidly changing - the age of onset of puberty is decreasing and the age at which mature social roles are achieved is rising. New understandings of the diverse and dynamic effects on adolescent health include insights into the effects of puberty and brain development, together with social media. A focus on adolescence is central to the success of many public health agendas, including the Millennium Development Goals aiming to reduce child and maternal mortality and HIV/AIDS, and the more recent emphases on mental health, injuries, and non-communicable diseases..."

2. Adolescence and the social determinants of health
Russell M Viner, Elizabeth M Ozer, Simon Denny, Michael Marmot, Michael Resnick, Adesegun Fatusi, Candace Currie
"...We review existing data on the effects of social determinants on health in adolescence, and present findings from country-level ecological analyses on the health of young people aged 10-24 years. The strongest determinants of adolescent health worldwide are structural factors such as national wealth, income inequality, and access to education. Furthermore, safe and supportive families, safe and supportive schools, together with positive and supportive peers are crucial to helping young people develop to their full potential and attain the best health in the transition to adulthood. Improving adolescent health worldwide requires improving young people's daily life with families and peers and in schools, addressing risk and protective factors in the social environment at a population level, and focusing on factors that are protective across various health outcomes. The most effective interventions are probably structural changes to improve access to education and employment for young people and to reduce the risk of transport-related injury..."

3. Worldwide application of prevention science in adolescent health
Richard F Catalano, Abigail A Fagan, Loretta E Gavin, Mark T Greenberg, Charles E Irwin Jr, David A Ross, Daniel T L Shek
"...Since this transition, the prevention of non-communicable disease as well as communicable disease causes of adolescent mortality has risen in importance. Problem behaviours that increase the short-term or long-term likelihood of morbidity and mortality, including alcohol, tobacco, and other drug misuse, mental health problems, unsafe sex, risky and unsafe driving, and violence are largely preventable. In the past 30 years new discoveries have led to prevention science being established as a discipline designed to mitigate these problem behaviours....This understanding has led to the construction of developmentally appropriate prevention policies and programmes that have shown short-term and long-term reductions in these adolescent problem behaviours. We describe the principles of prevention science, provide examples of efficacious preventive interventions, describe challenges and potential solutions to take efficacious prevention policies and programmes to scale, and conclude with recommendations to reduce the burden of adolescent mortality and morbidity worldwide through preventive intervention..."

4. Health of the world's adolescents: a synthesis of internationally comparable data
George C Patton, Carolyn Coffey, Claudia Cappa, Dorothy Currie, Leanne Riley, Fiona Gore, Louisa Degenhardt, Dominic Richardson, Nan Astone, Adesola O Sangowawa, Ali Mokdad, Jane Ferguson
"We derive indicators from the conceptual framework for the Series on adolescent health and assess the available data to describe them....Even with [the] optimisation of data usage, only seven of the 25 indicators, covered at least 50% of the world's adolescents....We propose a series of steps that include better coordination and use of data collected across countries, greater harmonisation of school-based surveys, further development of strategies for socially marginalised youth, targeted research into the validity and use of these health indicators, advocating for adolescent-health information within new global health initiatives, and a recommendation that every country produce a regular report on the health of its adolescents."


From Global Health TV, Professor Sir Michael Marmot discusses the effects social and economic policy has on adolescence and health and how we might improve worldwide well-being within this demographic. For this interview, click here.